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New & Scared: hellp, c-section, preemie...

Hi, I'm Sara. I delivered my 2nd son 6 days ago. I developed HELLP at 34 weeks and Henry was born via emergency c-section very quickly and I still feel a bit of shock over the whole thing. I had never intended to breastfeed him since I didn't breastfeed my first son (for no good reason really) - but have him be so small and vulnerable, my brain suddenly "clicked" and I'm dead set on breastfeeding this little guy. BUT... I'm starting from super scratch.

I'm pumping at home with a hospital rented pump (medela lactina I believe it is called) and am pumping 7 times during the day plus once at night if I wake up. I'm recovering from a c-section, and I wasn't able to pump in the hospital until 2 full days after he was born because I was still so ill.

I'm not making enough to feed him exclusively on breastmilk, and they NICU nurses are fortifying what I give them, and are really encouraging to me. I have seen the lactation lady at the hospital but she wasn't in today and I have a few worries...

I don't feel like I'm making enough. With 7-8 pumps a day, I'm averaging about 25 cc's (just under one ounce) per pump session. (That is as of today, which is 6 days after giving birth). I'm keeping myself well hydrated, I have my in-laws with me to help take care of my toddler, and I'm eating well.

Is it unusual to be not be making more milk? I expected more by this point. My problem isn't really that he's getting fortifier as well as my milk... my problem is my worry that my supply won't ever increase, and might just dwindle off since it isn't getting any stronger.

I'm an absolute wreck over this really... like I said I hadn't prepared myself at all to breastfeed, and my mother died only 2 weeks before my preemie was born so I don't have my own mommy to call up and ask for help. Like I said, the lactation lady at the hospital is very helpful and I know I'll get good support through her and elsewhere, but for right now until she's back I'm just trying to feel better about what I feel like is my body's total inability to take care of this child. First it failed on me by having a string of miscarriages, then it failed on me by having a premature baby, and I don't trust it enough to not fail on me now even though I'm desperate to suceed with this.

Thank you for listening to the admittedly hormone-driven rant... I just want what is best for my little guy and worried that I can't give that to him.

Re: New & Scared: hellp, c-section, preemie...

Congratulations on the new baby, I wish you all a lifetime of health and happiness!
I am so sorry that this exciting time has been so difficult on you. You have a lot on your plate and I know all you want is to bring the new little guy home. I had a lot of trouble getting lo to latch on and I too insisted on breast milk, so I was pumping a lot for her first 2 weeks of life. At first, I pumped just drips of milk. I discovered the more stressed I became, the less milk I would be able to pump. I found that if I could pump in the most comfortable area in my home where I could try to relax peacefully, I would successfully pump enough milk to feed her. It will be hard considering the extra stress you are dealing with, but I believe if you can just try to relax and think of all the nice moments you will have with ds in the near future, your milk will come in.

Hang in there, you're doing a great job, mama!!!!!!!!!!!
I hope ds comes home very soon.

Re: New & Scared: hellp, c-section, preemie...

Congrats on the new baby and on your decision to BF. I know just how you feel about that -- when your LO is in the hands of all the doctors and nurses you need to do SOMETHING.

I think an ounce each session after just four days is pretty good since I wasn't getting that much until a couple of weeks in. The first two days, I got nothing. So you're not alone (btw, DS is 10 months old now and still nursing).

The night DS was born my DH went home and got the nursery together so I could pump. We took a picture of DS in his isolette and I pumped in the nursery whenever I was home. The hardest thing was getting up at night -- but if you're only pumping every 3 hours during the day and not getting up every four hours at night (3 is better), start setting an alarm. I was miserable doing this, but it does help your supply, and when you see your LO grow you'll be so proud!

Some things that helped me:
Being in the nursery, in the chair I knew I would nurse in.
Low lights, especially at night.
Soothing music (I have an Enya CD that got me through those 29 nights!)

Does the NICU allow you to do kangaroo care (skin to skin)? Do it as often as you can -- ask the nurses if the nurses don't offer. I was sometimes afraid to ask to hold my own son because everything was so foreign to me -- and I had to get over that really fast.

Us NICU moms learn quickly that we're stronger than we ever realized. Relax. Remember that your LO is counting on you to be there for him now -- let him inspire you! GL

Re: New & Scared: hellp, c-section, preemie...

Your Doing Great!!! My milk did not come in until day 7 of my daughter in the NICU. I was just bringing the colustrum into them in a syrange and once my milk did come in, I was only able to get around 10 cc per pump session (I pumped every 2 hours). Keep with it. Once baby is at the breast, it gets better. My daughter was exclusivly breastfed for over 13 months and is now 15 months and still going strong.

Re: New & Scared: hellp, c-section, preemie...

Congrats! Welcome Henry!

Here's a few suggestions:

1. Get back in touch with the IBCLC as soon as possible. She will be a great resource for you, especially when it comes to hospital routines.
2. Call your nearest LLL Leader. She'll be there for you with information, and support.
3. You may be feeling stressed. Definitely take a few deep, cleansing breaths before pumping. Do whatever makes you feel relaxed, and takes your mind off any problems you have. Some mothers like to listen to soothing music. Others like to distract themselves with t.v. or even the computer. Whatever works best for you.
4. Use the techniques for assisting MER found on this page: http://www.lactationinstitute.org/MANUALEX.html before pumping. If the milk slows down while pumping, you can take a break and start the process over.
5. Find a comfortable area of your home/the hospital to pump in.
6. Wrap a blanket around your shoulders to keep you warm. Maybe even sit near a source of heat.
7. Kangaroo mother care will help both your milk production AND your baby's temperature and oxygen levels. Do it as much as you can.
8. When at the hospital, consider pumping near your baby's isolette where you can see, hear, and smell him.
9. Consider power pumping at least once per day. This is where you pump for 10 minutes, rest for 10 for a total of 60 minutes (30 minutes of pumping). This technique mimics cluster feeding and it often helps to trigger an icrease in production.

Re: New & Scared: hellp, c-section, preemie...

I totally agree with pps!

Congratulations, mama! You're doing the right thing by bfing, and as the new 1st time mom of a 35-weeker, I can appreciate your anxiety about having your milk come in and wondering if you'll be able to do it. I went through the EXACT SAME set of feelings that you described.

My milk didn't come in until day 6 (and even then, it wasn't much), and my husband was absolutely crazy with the idea that I wouldn't be physically able to feed my son. He wanted to push formula on like, day 2 after delivery. Thank goodness for the wonderful NICU nurses and lactation consultants! We had to supplement him like once or twice, but that was it.

Some things that really helped me establish a bf relationship with my LO in the NICU:

1) I spent every minute I could in the NICU feeding, talking, and holding my LO. I actually mentally imaged my milk coming in (the power of positive thinking?) and me successfully breastfeeding him.
2) In my case, I was able to go up to the NICU every three hours to feed him -- and yes, I set alarms to wake myself up to get there. After coming back from the NICU, I pumped (this is while I was still in the hospital). It was pretty discouraging seeing not much coming out of the pump, but the nipple stimulation did seem to help.

Some things I wish I had known:
1) A stressful/traumatic delivery can delay your milk coming in -- don't feel guilty!
2) A pumping bra/bustier makes your life sooooo much easier, and actually helps you relax while pumping. I recommend you get one RIGHT away. I found I wasn't as tense while pumping when I didn't have to hold the bottles -- and I didn't look down at the output and freak out as often.
3) Things improved significantly when my son was OUT of the stressful environment of the NICU -- all the bleeps, crying, bright lights, and noise freaked him out, too. Once he was able to room in with me (7 days later) and I was able to nurse him on demand, things really got going. The rigid schedules of a NICU are necessary for the nurses to retain their sanity, but they're not necessarily the greatest for helping you to relax and enjoy your baby.

Hang in there and let us know how you're doing! If you want, send me a private message and we can keep corresponding by email. I REALLY, REALLY sympathize -- I was right where you are! Don't give up!

PS...my little guy is now 2 months old (1 month corrected age), and is thriving on breastmilk! He's getting better all the time, and growing rapidly. Bfing a preemie is hard, but rest assured in the knowledge that your body will produce milk that is especially suited to the needs of your premature baby. You can do this!

Re: New & Scared: hellp, c-section, preemie...

What they said. A week after my 32-weeker was born, I was probably making about as much as you. Holding the baby & pumping every 3 hours even during the night helped a lot (that 8th pumping of the day really upped my supply.) Also, once they let you breastfeed or attempt to breastfeed even once a day that will help. The lactation consultants were there the first several times I was trying to BF and it was good, there were several different ones so even if one wasn't that helpful the next day I might get one that was.

Re: New & Scared: hellp, c-section, preemie...

I just want to say that all the previous posters have given great advice.

Are they letting you pump while you are in the NICU visiting? What was the turning point for me was being able to pump while my husband held our LO. I was then able to visualize this when I went home to pump. And like one of the pp said, once you are able to put the baby to breast, your milk will increase. Trust me. This is my second time BFing and I was shocked how little I was getting when I was pumping. But, we haven't had to supplement at all since our LO came home.

Try (as hard as it may seem) to relax while you pump. You are doing great! Also, remember that babies are much more efficient at getting milk out of your breasts than any pump, so the amount you pump now isn't an indicator of how your supply will be once you are nursing the baby.

Re: New & Scared: hellp, c-section, preemie...

I have to say, I burst into tears when I read your post. I so vividly remember those days of having a premmie which were upsetting enough but to have your Mum die as well must be so, so distressing! Well done for making the decision to breastfeed and my goodness, well done for producing so much milk, I know it doesn't look like much but for a baby with a stomach the size of a walnut it's a lot! I am in Ireland and have to say there is an odd attitude to breastfeeding here. Only 31% of new mothers breastfeed, the lowest rate in Europe, and I did find it was reflected in the attitude of Irish nurses. Luckily we also have lots of Asian doctors and nurses and they did encourage me to put Tom to the breast. That, I'm convinced, did wonders for my supply even though he just messed around on the breast for a couple of days before really getting latched on. Once we got home he was exclusivly breastfed, this on the advice of an Asian doctor, the home-grown nurses were keen on top-ups! Well, I'm happy to tell you that at 5 months old, ( 3 months corrected) Tom was so happy at the breast that he refused bottles! This was mightily inconvenient for me as I had to go back to work but it was a proud moment too because it showed how much success we had had. I really wish you all the best, any breastmilk is liquid gold and you have given your baby a fantastic start.